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CardioVascular and Interventional Radiology

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01-11-2008 | Clinical Investigation

Radiographic Response to Yttrium-90 Radioembolization in Anterior Versus Posterior Liver Segments

Authors: Saad M. Ibrahim, Robert J. Lewandowski, Robert K. Ryu, Kent T. Sato, Vanessa L. Gates, Mary F. Mulcahy, Laura Kulik, Andrew C. Larson, Reed A. Omary, Riad Salem

Published in: CardioVascular and Interventional Radiology | Issue 6/2008

Abstract

The purpose of our study was to determine if preferential radiographic tumor response occurs in tumors located in posterior versus anterior liver segments following radioembolization with yttrium-90 glass microspheres. One hundred thirty-seven patients with chemorefractory liver metastases of various primaries were treated with yttrium-90 glass microspheres. Of these, a subset analysis was performed on 89 patients who underwent 101 whole-right-lobe infusions to liver segments V, VI, VII, and VIII. Pre- and posttreatment imaging included either triphasic contrast material-enhanced CT or gadolinium-enhanced MRI. Responses to treatment were compared in anterior versus posterior right lobe lesions using both RECIST and WHO criteria. Statistical comparative studies were conducted in 42 patients with both anterior and posterior segment lesions using the paired-sample t-test. Pearson correlation was used to determine the relationship between pretreatment tumor size and posttreatment tumor response. Median administered activity, delivered radiation dose, and treatment volume were 2.3 GBq, 118.2 Gy, and 1,072 cm³, respectively. Differences between the pretreatment tumor size of anterior and posterior liver segments were not statistically significant (p = 0.7981). Differences in tumor response between anterior and posterior liver segments were not statistically significant using WHO criteria (p = 0.8557). A statistically significant correlation did not exist between pretreatment tumor size and posttreatment tumor response (r = 0.0554, p = 0.4434). On imaging follow-up using WHO criteria, for anterior and posterior regions of the liver, (1) response rates were 50% (PR = 50%) and 45% (CR = 9%, PR = 36%), and (2) mean changes in tumor size were −41% and −40%. In conclusion, this study did not find evidence of preferential radiographic tumor response in posterior versus anterior liver segments treated with yttrium-90 glass microspheres.

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Title: Radiographic Response to Yttrium-90 Radioembolization in Anterior Versus Posterior Liver Segments
Authors: Saad M. Ibrahim
Robert J. Lewandowski
Robert K. Ryu
Kent T. Sato
Vanessa L. Gates
Mary F. Mulcahy
Laura Kulik
Andrew C. Larson
Reed A. Omary
Riad Salem
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 6/2008
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-008-9348-y

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Radiographic Response to Yttrium-90 Radioembolization in Anterior Versus Posterior Liver Segments

Abstract

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